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Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up

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Abstract

Background

Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents.

Methods

A systematic review was conducted to pool available data on the longest available (>3 years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery.

Results

A total of 14 studies reporting the result of bariatric surgery after 3 years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19 years and from 26 to 91 kg/m2, respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n = 453) and adjustable gastric banding (n = 265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23 years). On average, patients lost 13.3 kg/m2 of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain < 5 kg/m2 between 5 and 6 years of follow-up. Removal, exchange, or conversion of the previous band constituted the majority of the revisional procedures. Three deaths were reported. No long-term data was obtainable on nutritional deficiency or growth status of adolescents who underwent a bariatric procedure.

Conclusion

Although bariatric surgery is a safe and effective procedure in the treatment of adolescent morbid obesity, long-term data is scarce regarding its nutritional and developmental complication in this growing population of patients.

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References

  1. Chinn S. Definitions of childhood obesity: current practice. Eur J Clin Nutr. 2006;60(10):1189–94.

    Article  CAS  PubMed  Google Scholar 

  2. Cole TJ, Bellizzi MC, Flegal KM, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Biro S, Barber D, Williamson T, et al. Prevalence of toddler, child and adolescent overweight and obesity derived from primary care electronic medical records: an observational study. CMAJ Open. 2016;4(3):E538–E44.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Chung A, Backholer K, Wong E, et al. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obes Rev. 2016;17(3):276–95.

    Article  CAS  PubMed  Google Scholar 

  5. Kindel TL, Lomelin D, McBride C, et al. Plateaued national utilization of adolescent bariatric surgery despite increasing prevalence of obesity-associated co-morbidities. Surg Obes Relat Dis. 2016;12(4):868–73.

    Article  PubMed  Google Scholar 

  6. Kelleher DC, Merrill CT, Cottrell LT, et al. Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009. JAMA Pediatr. 2013;167(2):126–32.

    Article  PubMed  Google Scholar 

  7. Inge TH, Courcoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374(2):113–23.

    Article  CAS  PubMed  Google Scholar 

  8. White B, Doyle J, Colville S, et al. Systematic review of psychological and social outcomes of adolescents undergoing bariatric surgery, and predictors of success. Clin Obes. 2015;5(6):312–24.

    Article  CAS  PubMed  Google Scholar 

  9. Paulus GF, de Vaan LE, Verdam FJ, et al. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015;25(5):860–78.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Willcox K, Brennan L. Biopsychosocial outcomes of laparoscopic adjustable gastric banding in adolescents: a systematic review of the literature. Obes Surg. 2014;24(9):1510–9.

    Article  PubMed  Google Scholar 

  11. Black JA, White B, Viner RM, et al. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obes Rev. 2013;14(8):634–44.

    Article  CAS  PubMed  Google Scholar 

  12. Panic N, Leoncini E, de Belvis G, et al. Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published systematic review and meta-analyses. PLoS One. 2013;8(12):e83138.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.

    Article  PubMed  Google Scholar 

  14. Nijhawan S, Martinez T, Wittgrove AC. Laparoscopic gastric bypass for the adolescent patient: long-term results. Obes Surg. 2012;22(9):1445–9.

    Article  CAS  PubMed  Google Scholar 

  15. Nehus EJ, Khoury JC, Inge TH, et al. Kidney outcomes three years after bariatric surgery in severely obese adolescents. Kidney Int. 2017;91(2):451–8.

  16. Paulus GF, Konings G, Bouvy ND, et al. Long-term follow-up is essential to assess outcome of gastric banding in morbidly obese adolescents: a retrospective analysis. Obes Facts. 2016;9(5):344–52.

    Article  PubMed  Google Scholar 

  17. Vilallonga R, Himpens J, van de Vrande S. Long-term (7 years) follow-up of Roux-en-Y gastric bypass on obese adolescent patients (<18 years). Obes Facts. 2016;9(2):91–100.

    Article  PubMed  Google Scholar 

  18. Zitsman JL, DiGiorgi MF, Fennoy I, et al. Adolescent laparoscopic adjustable gastric banding (LAGB): prospective results in 137 patients followed for 3 years. Surg Obes Relat Dis. 2015;11(1):101–9.

    Article  PubMed  Google Scholar 

  19. Cozacov Y, Roy M, Moon S, et al. Mid-term results of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass in adolescent patients. Obes Surg. 2014;24(5):747–52.

    Article  PubMed  Google Scholar 

  20. Osorio A, Moreira-Pinto J, Pereira J, et al. 9 Years after the first laparoscopic adjusted gastric banding (LAGB) in adolescents: the Portuguese experience. Eur J Pediatr Surg. 2011;21(5):331–4.

    Article  CAS  PubMed  Google Scholar 

  21. Silberhumer GR, Miller K, Pump A, et al. Long-term results after laparoscopic adjustable gastric banding in adolescent patients: follow-up of the Austrian experience. Surg Endosc. 2011;25(9):2993–9.

    Article  PubMed  Google Scholar 

  22. Widhalm K, Fritsch M, Widhalm H, et al. Bariatric surgery in morbidly obese adolescents: long-term follow-up. Int J Pediatr Obes. 2011;6(Suppl 1):65–9.

    Article  PubMed  Google Scholar 

  23. de la Cruz-Munoz N, Messiah SE, Cabrera JC, et al. Four-year weight outcomes of laparoscopic gastric bypass surgery and adjustable gastric banding among multiethnic adolescents. Surg Obes Relat Dis. 2010;6(5):542–7.

    Article  PubMed  Google Scholar 

  24. Widhalm K, Dietrich S, Prager G, et al. Bariatric surgery in morbidly obese adolescents: a 4-year follow-up of ten patients. Int J Pediatr Obes. 2008;3(Suppl 1):78–82.

    Article  PubMed  Google Scholar 

  25. Papadia FS, Adami GF, Marinari GM, et al. Bariatric surgery in adolescents: a long-term follow-up study. Surg Obes Relat Dis. 2007;3(4):465–8.

    Article  PubMed  Google Scholar 

  26. Sugerman HJ, Sugerman EL, DeMaria EJ, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg. 2003;7(1):102–7. discussion 7-8

    Article  PubMed  Google Scholar 

  27. Nguyen NT, Karipineni F, Masoomi H, et al. Increasing utilization of laparoscopic gastric banding in the adolescent: data from academic medical centers, 2002-2009. Am Surg. 2011;77(11):1510–4.

    PubMed  Google Scholar 

  28. Khorgami Z, Shoar S, Andalib A, et al. Trends in utilization of bariatric surgery, 2010–2014: sleeve gastrectomy dominates. Surg Obes Relat Dis. 2017. doi:10.1016/j.soard.2017.01.031.

  29. Pallati P, Buettner S, Simorov A, et al. Trends in adolescent bariatric surgery evaluated by UHC database collection. Surg Endosc. 2012;26(11):3077–81.

    Article  PubMed  Google Scholar 

  30. Obeid T, Krishnan A, Abdalla G, et al. GERD is associated with higher long-term reoperation rates after bariatric surgery. J Gastrointest Surg. 2016;20(1):119–24. discussion 24

    Article  PubMed  Google Scholar 

  31. Kellogg TA, Swan T, Leslie DA, et al. Patterns of readmission and reoperation within 90 days after roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5(4):416–23.

    Article  PubMed  Google Scholar 

  32. Gribsholt SB, Thomsen RW, Svensson E, et al. Overall and cause-specific mortality after Roux-en-Y gastric bypass surgery: a nationwide cohort study. Surg Obes Relat Dis. 2017;​13(4):581–7.

  33. Davidson LE, Adams TD, Kim J, et al. Association of patient age at gastric bypass surgery with long-term all-cause and cause-specific mortality. JAMA Surg. 2016;151(7):631–7.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine and Surgery, Tehran University of Medical Sciences, No17, Isar 2 Alley, Khandaee street, Kashan, Tehran, 8719757161, Iran

    Saeed Shoar

  2. Department of Surgery, Cancer Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Saeed Shoar, Habibollah Mahmoudzadeh & Mohammad Naderan

  3. Department of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

    Shahram Bagheri-Hariri

  4. Weight Loss Center, The Brooklyn Hospital, Brooklyn, NY, USA

    Catherine Wong

  5. Department of Epidemiology and Statistics, University of Groningen, Groningen, Netherlands

    Ahmad Shahabeddin Parizi

  6. Department of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran

    Nasrin Shoar

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  1. Saeed Shoar
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  2. Habibollah Mahmoudzadeh
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Correspondence to Saeed Shoar.

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Shoar, S., Mahmoudzadeh, H., Naderan, M. et al. Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3 years Follow-Up. OBES SURG 27, 3110–3117 (2017). https://doi.org/10.1007/s11695-017-2738-y

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  • DOI: https://doi.org/10.1007/s11695-017-2738-y

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